Does Treatment of Adolescent Fractures Differ between Specialties? A Survey among Pediatric and Trauma Surgeons

TL;DR

Pediatric and trauma surgeons differ in how they treat adolescent fractures, with trauma surgeons preferring more invasive methods.

Contribution

The study reveals significant treatment preference differences between pediatric and trauma surgeons for adolescent fractures.

Findings

Trauma surgeons tend to choose more operative and invasive treatments for adolescent fractures.

Pediatric surgeons may underestimate the severity of fractures resembling adult cases.

Interdisciplinary collaboration is needed to improve treatment guidelines for adolescents.

Abstract

From a traumatological point of view, adolescents (12–18 years) represent a special group of patients. This is due to their biomechanical characteristics being between pediatric and adult fracture types. In Germany, they are treated by both pediatric and trauma surgeons. For this survey, seven cases of adolescent fractures were evaluated by both pediatric and trauma surgeons and their preferred treatment options were raised. The questionnaires were completed anonymously. Additionally, information on the specialty and years of experience were asked. In total, 126 valid questionnaires were obtained (from 78 pediatric and 48 trauma surgeons). The respondents’ mean clinical experience was high (71.5% stated more than 10 years of surgical experience). For every single exemplary case, a significant difference in therapy decisions between the groups could be found. For the demonstrated seven cases, a tendency toward more operative and more invasive treatments was found with trauma surgeons compared to pediatric surgeons. On the other hand, there was a risk of underestimating the severity of fracture entities similar to adult fractures in pediatric surgeons. Overall, a continuous interdisciplinary exchange between both surgical specialties is necessary to ensure optimal treatment for adolescent fractures and to develop guidelines in the future.

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